scholarly journals Extradural Haematoma in Children: Surgical Experiences and Prospective Analysis of 138 Cases

2014 ◽  
Vol 1 (1) ◽  
pp. 19-24
Author(s):  
Sharif Md. Noman Khaled Chowdhury ◽  
Abdul Hanif ◽  
K M Tarikul Islam ◽  
Ehsan Mahmud ◽  
Sk. Sader Hossain
Keyword(s):  
Traffic Accident ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Road Traffic ◽  
Time Interval ◽  
Extradural Haematoma ◽  
Age Group ◽  
Mortality And Morbidity ◽  
Common Clinical Presentation ◽  
Operative Measures

Objective: The authors present their experiences in the management of xtradural haematoma in children which involved an aggressive diagnostic approach, prompt surgical evacuation of the haematoma results in an excellent outcome.Subjects and methods: 138 consecutive patients with cranial extradural haematoma who underwent surgery in department of Neurosurgery from 1st January 2006 to 31st July 2009 were included in this prospective study. Each of the patients were evaluated in term of age, sex, mode of injury, localization of haematoma, clinical presentation, CT findings, operative measures and outcome.Results: Out of 138 cases 72.47 % were boys and 13.78 % were girls. The boys and girls ratio was 2.64: 1. Age ranges from 1.8 to 15 years with a mean age of 9.49 years. Most of the victims are in first half of second decade of life and closely followed by the 5-10 years age group. The most common mode of injury was fall 40.58 %, (n = 56) followed by Road traffic Accident (RTA) 31.89 %, (n = 44) .The Most common clinical presentation was altered sensorium 59.43 %, (n = 82), followed by Headache / Vomiting 56.53 %, (n = 78).Conclusion: Extradural haematoma in children is a recognized and one of the most rewarding neurosurgical emergencies. It must be recognized and evacuate early to prevent potential mortality and morbidity. Many factors affect the outcome of extradural haematoma surgery. In addition to influence of presence cranial fractures, associated brain lesions and pre-operative neurological condition of patient, duration of time interval between onset of coma and surgical intervention, morbidity and mortality have also been shown to be affected by age – with better prognosis in patients under 10 years of age.DOI: http://dx.doi.org/10.3329/jpsb.v1i1.19450

Surgical management of traumatic extradural haematoma: Experiences with 610 patients and prospective analysis

2008 ◽  
Vol 05 (02) ◽  
pp. 75-79 ◽  
Author(s):  
Chowdhury Noman Khaled ◽  
MZ Raihan ◽  
FH Chowdhury ◽  
ATM Ashadullah ◽  
MH Sarkar ◽  
...  
Keyword(s):  
Prospective Study ◽  
Brain Injuries ◽  
Clinical Presentation ◽  
Road Traffic ◽  
Time Interval ◽  
Extradural Haematoma ◽  
Female Ratio ◽  
Medical College ◽  
Ct Findings ◽  
Operative Measures

AbstractThis study was carried out to find out the age, sex, mode of injury, localization, clinical presentation, CT findings, operative measures and outcome of extradural haematoma in the patient population at Dhaka Medical College. 610 consecutive patients with cranial extradural haematoma who underwent surgery in department of Neurosurgery from 1st January 2006 to 6th October 2008 were included in this prospective study. Each of the patients were evaluated in term of age, sex, mode of injury, localization of haematoma, clinical presentation, CT findings, operative measures and outcome. Out of 610 cases 86.32 % were male and 13.78 % were female. The male and female ratio was 6.27: 1. Age ranged from 2.5 to 83 years. Commonest age group was 21 to 30 years. Commonest mode of injury was Road traffic Accident 53.45%, followed by Assaults. Most common clinical presentation was headache / Vomiting 63.61 %, followed by altered sensorium 60.66 %. In this present prospective study of 610 cases of EDH, temporo parietal site was involved in 33.45 % followed by frontal region in 23.28 %. Sixty five patients (10.66 %) died; 19 of these had associated brain injuries and 28 cases were deeply unconscious. Extradural haematoma is a neurosurgical emergency where early surgical intervention is associated with the best prognosis. Many factors affects the outcome of extradural haematoma surgery and the most important one is the duration of time between incident/accident and operation in neurosurgical operation theater; mortality can be close to 0% if this time interval can be minimized.

P16 Relation of timing of surgery to outcome from traumatic acute subdural haematoma

2019 ◽  
Vol 90 (3) ◽  
pp. e30.1-e30
Author(s):  
M Paranathala ◽  
S Quake ◽  
M Prasad
Keyword(s):  
Mortality Rate ◽  
Patient Outcomes ◽  
Surgical Intervention ◽  
Road Traffic ◽  
Rank Correlation ◽  
Time Interval ◽  
Acute Subdural Haematoma ◽  
Mortality And Morbidity ◽  
Spearman Rank Correlation Test ◽  
Overall Mortality

ObjectivesAcute subdural haemorrhage (ASDH) is a neurosurgical emergency with high mortality and morbidity rates. Time to surgical intervention is implicated as an important factor affecting patient outcomes, however, more recent studies do not support this. We aimed to determine the correlation between time interval to surgery and outcome of patients with traumatic ASDH.MethodsWe retrospectively reviewed consecutive ASDH patients who underwent haematoma evacuation in the period between 2010 and 2016 at this tertiary neurosurgical centre. 49 patients were included for the analysis. Patient data was extracted from theatre records, patient notes and electronic records.ResultsThe median time interval from injury to surgery was 403 min (6 hours 43 min) with road traffic accident being the commonest mechanism of injury. 20 of 49 (34.7%) patients underwent evacuation within five hours from time of injury. Of these, 12 (41.4%) had good recovery (GOS 5), versus 15 (51.7%) amongst the 29 patients who underwent operation after five hours. Spearman rank correlation test (rs=0.07375) showed no statistically significant correlation between time interval to surgery and patient outcomes as measured by GOS. The overall mortality rate of evacuated patients at JCUH was 8.16% and the majority had good functional status, 55.1% with GOS 5.ConclusionsLonger time interval of more than four hours from injury to surgical intervention was not associated with higher mortality rate, or worse functional outcome.

scholarly journals Epidemiology of Fatal Injuries reported in the mortuary of a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 633
Author(s):  
Subrat Kumar Pradhan ◽  
Himansu Prasad Acharya ◽  
Rudra Prasanna Mishra ◽  
Jay Kumar Panda ◽  
Durga Madhab Satapathy ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Adult Population ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Care Hospital ◽  
Age Group ◽  
Microsoft Excel ◽  
Mortality And Morbidity ◽  
Fatal Injuries

Background: Injuries are an increasingly recognized global, preventable public health problem and are an important cause of mortality and morbidity in adult population. The major causes of injury related deaths may be intentional and unintentional. The major unintentional or “accidental” causes are road traffic accidents (RTAs), falls and drowning whereas the leading intentional causes are suicide and homicide. A robust Surveillance System for Injury Mortality is almost non-existent in our country due to which the data for the same is not available and haphazard. Keeping these factors in mind, the following study was under taken to identify the various epidemiological factors related to fatal injury cases.Methods: A record based retrospective study was conducted in the Department of Community Medicine, VSSIMAR, Burla, Odisha. The data were collected from the autopsy reports preserved at the Dept of FM & T, VSSIMSAR. Variables like age, sex, number of injury cause of death, place of death etc. were collected. Data were entered in Microsoft Excel and analysed using proportions and percentages.Results: The age group 25-44 years recorded the maximum number of deaths (37.49%). Males suffered the highest casualty accounting for 61.85% of deaths. Unintentional fatal injuries constituted 63.58% of deaths. The most number of fatal injuries resulting in deaths were RTAs (36.41%).Conclusions: The age group 25-44 years recorded maximum deaths. Males were the major death victims. RTAs constituted maximum of deaths among unintentional fatal injuries. Homicidal injuries constituted maximum of deaths due to intentional fatal injuries.

Trends and outcomes of ruptured ovarian cysts

2021 ◽  
pp. postgradmedj-2020-138833
Author(s):  
Wei How Lim ◽  
Nikki Woods ◽  
Vincent P Lamaro
Keyword(s):  
Emergency Department ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Ovarian Cysts ◽  
Free Fluid ◽  
Vaginal Intercourse ◽  
Imaging Diagnosis ◽  
Retrospective Audit ◽  
Common Clinical Presentation ◽  
Health Institutions

BackgroundRuptured ovarian cysts are common gynaecological presentation to health institutions with abdominal pain. While this phenomenon is generally self-limiting, surgery may be necessary in cases of haemodynamic compromise or association with torsion. The aim of this audit is to identify the trend of hospital presentations, as well as the review the management of modern gynaecology practice.MethodsA retrospective audit of all women who presented to the emergency department with an imaging diagnosis of ruptured ovarian cysts was conducted over a 5-year period at St Vincent’s Hospital, Sydney.ResultsDuring the study period, 408 women were identified. There was a trend towards conservative management, as observed in 84.7% of women, while the remaining 15.4% underwent surgery. Haemorrhagic or ruptured corpus luteum was the most common diagnoses. As expected, women who had surgical intervention were more likely to have larger cysts (20 vs 50%; p<0.05), and larger free fluid findings on imaging (1.4 vs 23.8%; p<0.05) compared with those managed conservatively. There were no statistically significant differences in location of ovarian cysts (right or left) or antecedent to hospital presentation (vaginal intercourse or trauma).ConclusionRuptured ovarian cysts of both functional and non-functional types remained a common clinical presentation of acute pain for women to the emergency department. Majority of women were managed conservatively in our cohort, and indications for surgery were large ovarian cysts and large free fluid seen on imaging findings. Surgery was largely feasible with minimal complications.

scholarly journals Etiological Factors of Extradural Haematoma: Experience of 80 Cases in Bangladesh

2017 ◽  
Vol 14 (2) ◽  
pp. 44-48
Author(s):  
Md. Abdus Salam ◽  
Md. Shafiul Alam ◽  
Kalim Uddin ◽  
Md. Ashraful Haque ◽  
Md. Mahfuzur Rahman ◽  
...  
Keyword(s):  
Head Injury ◽  
Road Traffic ◽  
Cross Sectional Study ◽  
Extradural Haematoma ◽  
Age Group ◽  
Traumatic Head Injury ◽  
College Hospital ◽  
Cross Sectional ◽  
Etiological Factors ◽  
Traumatic Head

Background: Extradural haematoma is due to different etiologies.Objectives: The purpose of the present study was to see the etiological factors of extradural haematoma.Methodology: This cross sectional study was conducted in the Department of Neurosurgery at Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2010 to June 2011 for a period of one year and half months. All patients who underwent surgery with traumatic head injury having extradural haematoma were included in the study. At admission, a detailed history of the illness was taken from the patients/patient’s attendants by face-to-face interview with the help of a preformed questionnaire. Questionnaire was prepared with key variables like age, sex and mode of injury.Result: Eighty (80) patients of traumatic head injury within and after 24 hours of head injury were enrolled in this study. 20(25.1%) patients were present in age group of 11 to 20 years. 19(23.8%) patients were in age group of 21-30 years. 20(25.1%) patients were present in age group of 31 to 40 years. Male was predominant than female which was 60(75.0%) cases and 20(25.0%) cases respectively. The most common mode of injury was road traffic accident which was 51(63.7%) cases followed by fall from height and assault which were 16(20.0%) cases and 13(16.3%) cases respectively.Conclusion: In conclusion RTA is the most common cause of extradural haematoma.Journal of Science Foundation, July 2016;14(2):44-48

scholarly journals Carotid-Cavernous Fistula: An Uncommon and Easily Missed Complication of Head Trauma

2005 ◽  
Vol 12 (2) ◽  
pp. 95-98
Author(s):  
KH Lau ◽  
CP Ng ◽  
CH Chung
Keyword(s):  
Head Injury ◽  
Traffic Accident ◽  
Road Traffic ◽  
Emergency Physicians ◽  
Carotid Cavernous Fistula ◽  
Mortality And Morbidity ◽  
Cavernous Fistula ◽  
The Right ◽  
Direct Carotid Cavernous Fistula ◽  
Uncommon Complication

A 57-year-old woman attended the emergency department complaining of protrusion of the right eyeball for three days. The history revealed that she had head injury in a road traffic accident about five weeks ago. The accident had caused a fracture of the right angle of the mandible that was fixed internally by the maxillo-facial surgeon. Subsequent angiogram showed a right direct carotid-cavernous fistula. Endovascular therapy was successful in obliterating the fistula. She recovered well. Although carotid-cavernous fistula is an uncommon complication of head injury, emergency physicians should be aware of this condition because of its potential mortality and morbidity.

scholarly journals EVALUATION OF RESULTS OF INTERNAL FIXATION OF CLOSED, DISPLACED, RECENT FRACTURE SHAFT OF HUMERUS BY MIPPO TECHNIQUE

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Alok Sobhan Datta ◽  
S. Velagada ◽  
A. Haque
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
High Energy ◽  
Time Interval ◽  
Shaft Fractures ◽  
Recent Fracture ◽  
Humerus Shaft

BACKGROUND: The humerus shaft fracture is the second most common fracture of the upper extremity. The predominant causes of humerus shaft fractures include low energy trauma such as fall from a standing height in older population, while in the younger population it is caused by high energy trauma. Aims and Objectives - To investigate the effectiveness of economical MIPPO technique and to determine the radiological and functional significance of MIPPO technique in the patients undergoing treatment for recent fracture shaft of humerus. MATERIALS AND METHODS: A prospective study had been carried out from December 2012 to August 2014 in the Orthopaedics Department of SSKM Hospital, Kolkata, West Bengal, India. Thirty three patients, who presented with fracture shaft of humerus and underwent fixation of humeral shaft fractures by MIPPO technique were included in this study. Complete history was taken and full clinical examination was carried out. RESULTS: The average age group in our study is 35.3 years. Of them 85% are male and 15% are female. In majority cases, mode of injury was road traffic accident. 85% cases had middle 1/3rd fracture shaft of humerus and the average time interval between the injury and surgery was 8.54 days. CONCLUSION: The results obtained in this study have shown that the MIPPO technique is safe, convenient and effective, since there was minimal soft tissue injury with no major complications. KEYWORDS: Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO); Road Traffic Accident (RTA).

scholarly journals A study on clinical and epidemiological profile of patients admitted with white patch in throat to Sir Ronald Ross Institute of Tropical and Communicable Diseases, Hyderabad, India

2018 ◽  
Vol 5 (5) ◽  
pp. 1984
Author(s):  
Asma . ◽  
Phani Bhushan Ivaturi
Keyword(s):  
Communicable Diseases ◽  
Age Group ◽  
White Patch ◽  
Cross Sectional ◽  
Course Of Illness ◽  
Mortality And Morbidity ◽  
Acute Infectious Disease ◽  
Common Clinical Presentation ◽  
Toxigenic Strains ◽  
Epidemiological Profile

Background: One of the most common differential diagnosis for a white patch in throat is diphtheria. Diphtheria is an acute infectious disease caused by toxigenic strains of corynebacterium diphtheriae. These bacilli release powerful exotoxin which is responsible for formation of white or greyish or yellowish membrane commonly over tonsils, pharynx or larynx. The objectives of the study were to determine the clinical and epidemiological factors of cases admitted with white patch in throat; to assess the microbiological confirmation rate of diphtheria among cases with white patch in throat; to identify the mortality and morbidity among study population.Methods: A cross sectional record based retrospective study was carried out at Sir Ronald Ross Institute of Tropical & Communicable Diseases, Hyderabad. All the cases admitted in year 2016 with a white/grey/yellowish patch in throat were included in the study. The study was carried out for 2 months.Results: A total of 230 cases were reported and 46.1% of cases were in the age group of 11-20 years. Males constituted about 48.3% and females 51.7% of study population. The most common clinical presentation was Sore throat, fever and a pseudo membrane over tonsils/pharynx. A total of 12 deaths occurred among 230 cases.Conclusions: Deaths occurred most commonly in the younger age group and in the non-immunized. Recovery was faster and the course of illness was uncomplicated in the older age group and in completely immunized individuals.

scholarly journals Traumatic Perforation of Tympanic Membrane: A Rural Profile of Bangladesh

2017 ◽  
Vol 28 (2) ◽  
pp. 79-82
Author(s):  
Jahangir Alam Mazumder ◽  
Syed Mohiuddin Nasir ◽  
Shazibur Rashid ◽  
Arif Morshed Khan
Keyword(s):  
Tympanic Membrane ◽  
Rural Areas ◽  
Healing Rate ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Age Group ◽  
Spontaneous Healing ◽  
Early Appearance ◽  
Major Mode ◽  
Type Of Injury

To determine the various etiological factors, clinical presentation and outcome of traumatic perforation of tympanic membrane (TM) in a rural area of Bangladesh. A retrospective study of 210 cases of traumatic perforation of TM in upazilla health complex, Nangalkot and Muradnagar, Comilla, Bangladesh within the period of March 2013 to February 2014. The study showed middle age people of 20-39 years age group were mostly affected (61.89%), where males are more than females at the ratio of 1.18:1. Domestic violence was a major factor (50%) and husbands are only culprit for 35.13% of housewives and slap was the major mode of injury (52.86%) affecting the left ear mostly (70.95%). Spontaneous healing rate was very satisfactory and it was 88% within 03 months in our study. Traumatic perforation of TM is a common type of injury in rural areas. Unnecessary surgical intervention or unskilled handling should be discouraged. Early appearance and watchful treatment reduces the morbidity.Medicine Today 2016 Vol.28(2): 79-82

scholarly journals An observational study of clinicoetiological profile of stroke patients in a new tertiary care hospital in North Odisha, India

2019 ◽  
Vol 7 (8) ◽  
pp. 3095
Author(s):  
Bibhu P. Behera ◽  
D. N. Maharana ◽  
Partha S. Mohanty
Keyword(s):  
Risk Factor ◽  
Hemorrhagic Stroke ◽  
Clinical Presentation ◽  
Age Group ◽  
Common Risk Factor ◽  
Anterior Circulation ◽  
Female Ratio ◽  
Common Clinical Presentation ◽  
Male To Female ◽  
The Brain

Background: Stroke is one of the leading causes of morbidity and mortality in India. The objective was to study the clinical profile, risk factors, neurological characters, pattern of brain stroke, areas of brain affected as per CT scan findings in patients with stroke.Methods: This observational study was carried out from June 2018 to Jan 2019 of all new patients admitted with stroke in Pandit Raghunath Murmu Medical College and Hospital, Baripada, Mayurbhanj, Odisha, India.Results: The incidence of stroke is maximum in 46-60 years of age group. The average age+SD was 59.3+13.5 in our study. 274 (46.52%) patients had ischemic stroke and 315 (53.48%) patients had hemorrhagic stroke. The male to female ratio was 1.46:1. Anterior circulation (86.42%) was the most common territory involved in the brain. The most common risk factor was hypertension with 77.76% followed by dyslipidemia (53.99%). The most common clinical presentation was hemiplegia (85.23%).Conclusions: The incidence of stroke is maximum in 46-60 years of age group. The average age+SD was 59.3+13.5 in our study. 274 (46.52%) patients had ischemic stroke and 315 (53.48%) patients had hemorrhagic stroke. The male to female ratio was 1.46:1. Anterior circulation (86.42%) was the most common territory involved in the brain. The most common risk factor was hypertension with 77.76% followed by dyslipidemia (53.99%). The most common clinical presentation was hemiplegia (85.23%). 

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